Many people do not understand why or how people become addicted to drugs and alcohol. There are many misconceptions about how addictions work. For example, some mistakenly believe that those who use drugs lack moral principles or willpower and could stop using drugs by simply choosing to do so. In reality, drug addiction is a complex disease and quitting takes much more than good intentions.

Drugs change the brain in ways that make quitting difficult even for those who want to. Fortunately, psychologists know more now than ever before about how drugs affect the brain and have found treatments that can help people recover.

What is a drug addiction?

To begin, addiction is a chronic disease characterized by drug seeking and use that is compulsive or difficult to control despite negative consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs.

How do addictions affect the brain?

The brain registers all pleasures in the same way whether it be from a satisfying meal, monetary reward or drug use. In the brain, instances of pleasure are marked by releases in certain neurotransmitters. All drugs of abuse cause a particularly powerful surge of dopamine, providing a “shortcut” to the brain’s reward system. While these neurotransmitters contribute to the experience of pleasure, they also play a role in memory and learning. This motivates a person to take action and seek out the source of pleasure from past experiences. For some, this explains how addiction becomes a learned behavior.

What are the risk factors for becoming an addict?

No one factor can predict if a person is going to become addicted to drugs. Instead, a combination of factors influences the risk of addiction. The more risk factors a person has, the higher chance that taking drugs can lead to addiction.

For example, the biology of someone can be a risk factor. The genes that a person is born with account for about half of a person’s risk for addiction. Gender, ethnicity, and the presence of other mental disorders all are potential risk factors. It has long been known that addicts usually have an under active dopamine system that gives them a decreased capacity to experience pleasure in their ordinary lives.

One’s environment also plays a factor. This includes family and friends, socioeconomic status, stress, parental guidance and early exposure to toxic environments. For example, growing up without both parents around will leave you at a risk to be exposed to drugs at a younger age, thus resulting in an increase of possible addiction.

Why do people use drugs as a way to “escape” their life?

Most psychological addiction begins with feelings that are out of control. Strong emotions like rage, jealousy, fear and hopelessness make some people feel helpless. To quell these uncomfortable feelings, abusers turn to drugs or alcohol.

At first, turning to substances to soothe unpleasant feelings is a choice. No one wakes up in the morning and decides they’re going to become a substance abuser or engage in a life-threatening compulsion. However, at some point, the behavior or drug of choice becomes a necessary ritual and takes over as the primary method of relieving strong feelings.

What are the different types of addictive behaviors?

The word addiction is used in several ways. One definition describes physical addiction, meaning the biological state in which the body adapts to the presence of drugs. This demonstrates itself by having a tolerance to drugs or the body reacting physically to triggers and cues associated with the drugs. For example, an alcoholic that walks into a bar may begin to sweat and get chills as they anxiously wait for their first drink.

However, there are also addictive behaviors that are psychologically based. People commonly use drugs in reaction to being stressed, whether or not they have a physical addiction. Since these psychologically based addictions are not based on drug or brain effects, they can account for why people frequently switch addictive actions from one drug to a completely different kind of drug. The focus of the addiction isn't what matters; it's the need to take action under certain kinds of stress. Treating this kind of addiction requires an understanding of how it works psychologically.

How do we treat addiction?

Psychological symptoms of addiction can be understood and treated, but not by dealing with them as lack of motivation or faulty thinking. Just getting clean and sober may not address the actual psychology of addiction. While breaking the physiological need for the drug, this does not break the persons desire to “escape” everyday life. Breaking psychological addiction requires a commitment to understanding the root causes of one’s personal addictive behavior and getting free from the destructive cycle. One of the hardest aspects of breaking psychological addiction is confronting unpleasant emotions, situations and people instead of avoiding them. This may mean taking positive, productive and proactive steps to manage a situation rather than swallowing the uncomfortable emotions it evokes and ending up in a binge.

Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients. Treatment approaches tailored to each patient’s drug use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery.

Addiction to drugs and alcohol should be treated as a psychological issue in order to end it completely. Understanding the psychology behind addictions allows us to help those with addictions overcome their problem and begin to live again.

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